You are evaluating a 3-year-old who acutely sustained a burn involving 5% of body surface, with injury limited to the epidermis and upper part of the dermis. How would you rate this burn?

You are evaluating a 3-year-old who acutely sustained a burn involving 5% of body surface, with injury limited to the epidermis and upper part of the dermis. How would you rate this burn?

• A. She has a minor first and second degree burn
• B. She has a major second degree burn
• C. She has a major first and second degree burns
• D. She has a major full thickness burn

Answer: (C)

In pediatric burns, severity is judged by both depth and total body surface area, because young children have less physiologic reserve and are more vulnerable to fluid loss and infection. A burn confined to the epidermis and the upper part of the dermis is a partial-thickness injury, classically called second-degree. If some skin areas are limited to the epidermis while other areas extend into the upper dermis, you have a mix of superficial (first-degree) and partial-thickness (second-degree) involvement. When a wound contains both depths, it’s described as mixed first- and second-degree. Adding that this child is 3 years old with 5% of body surface area burned, this threshold and depth combination meet criteria for a major burn in the pediatric population, necessitating more intensive evaluation and management. This is not full-thickness involvement, which would indicate a different severity pattern.

In pediatric burns, severity is judged by both depth and total body surface area, because young children have less physiologic reserve and are more vulnerable to fluid loss and infection. A burn confined to the epidermis and the upper part of the dermis is a partial-thickness injury, classically called second-degree. If some skin areas are limited to the epidermis while other areas extend into the upper dermis, you have a mix of superficial (first-degree) and partial-thickness (second-degree) involvement. When a wound contains both depths, it’s described as mixed first- and second-degree. Adding that this child is 3 years old with 5% of body surface area burned, this threshold and depth combination meet criteria for a major burn in the pediatric population, necessitating more intensive evaluation and management. This is not full-thickness involvement, which would indicate a different severity pattern.